| NPI | 1932295433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLYMPHIA A JACKSON M S PT 678-715-1544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA pt007580) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |